Blood on Toilet Paper: Rectal Pain and Symptoms

Blood on toilet paper after wiping can indicate several potential issues, such as hemorrhoids, anal fissures, or gastrointestinal bleeding?

Hello, Doctor.
I went to eat barbecue on Sunday and ended up with a stomachache.
I went to the bathroom four times after returning home.
The first bowel movement was normal, the second was somewhat formed, and the third and fourth were diarrhea.
Additionally, I experienced significant anal pain, and there was a little blood on the toilet paper when I wiped.
On Monday morning, my stool was not very solid, somewhat formed, and I felt a sharp pain in my anus.
The first time I wiped, there seemed to be blood mixed with mucus and stool, about the size of a one-dollar coin.
The second time I wiped, there was no blood, just stool.
On Tuesday morning, my bowel movement was better; I felt a sharp pain in my anus again, but there was no blood when I wiped.
On Wednesday morning, during my bowel movement, I felt slight anal pain, and there was no blood when I wiped.
My family checked my anus and found a small bump, about the size of the tip of my pinky finger.
I can also feel it when I touch it.
Throughout the day at work, I experience a sharp pain in my anus that feels like inflammation about 2-3 times, but it only lasts for a few seconds and is accompanied by itching, which also lasts just a few seconds.
Sitting, standing, or walking does not cause pain.
Doctor, do I need to go to the hospital for this?

yt.chan, 30~39 year old female. Ask Date: 2014/10/29

Dr. Ke Fangxu reply Surgery

This situation is likely caused by excessive bowel movements leading to swollen hemorrhoids.
As long as the symptoms gradually improve, there is no need for concern.
It is recommended to take warm sitz baths and you can also purchase hemorrhoid ointment for application, which typically provides relief within 3-5 days.
If symptoms persist or if there is a fever, it is important to seek medical attention promptly.

Reply Date: 2014/10/29

More Info

Based on your description, it seems that you are experiencing rectal pain and some bleeding after a recent episode of diarrhea. The symptoms you mentioned, including the presence of blood on toilet paper, pain during bowel movements, and the sensation of a small lump near the anus, could indicate a few potential issues that warrant further evaluation.

Firstly, the presence of blood mixed with stool or on toilet paper can be concerning. It may suggest a few possibilities, such as hemorrhoids, anal fissures, or more serious conditions like inflammatory bowel disease or even colorectal polyps. Hemorrhoids are swollen veins in the lower rectum or anus that can cause pain, itching, and bleeding, especially during bowel movements. Anal fissures are small tears in the lining of the anus, often caused by passing hard stools, which can lead to sharp pain and bleeding.

The fact that you experienced diarrhea and then noticed blood could indicate that the rapid changes in bowel habits may have contributed to the irritation or injury of the anal area. The lump you described could potentially be a thrombosed hemorrhoid or a skin tag, which can occur after episodes of straining or irritation.

Given that you have experienced intermittent pain and the sensation of inflammation, it is advisable to seek medical attention. A healthcare provider can perform a physical examination, which may include a visual inspection of the anal area and possibly a digital rectal exam to assess for any abnormalities. They may also recommend further tests, such as a colonoscopy, especially if there are concerns about more serious underlying conditions.

In the meantime, here are some general recommendations to help manage your symptoms:
1. Dietary Changes: Increase your fiber intake by consuming more fruits, vegetables, and whole grains. This can help soften your stool and reduce straining during bowel movements.

2. Hydration: Drink plenty of fluids to stay hydrated, which can also help prevent constipation.

3. Sitz Baths: Taking warm sitz baths can help soothe the anal area and relieve discomfort.

4. Over-the-Counter Medications: You may consider using over-the-counter topical treatments for hemorrhoids or pain relief, such as hydrocortisone creams or witch hazel pads.

5. Avoid Straining: Try to avoid straining during bowel movements, as this can exacerbate your symptoms.

6. Monitor Symptoms: Keep track of your symptoms, including any changes in bowel habits, the amount of bleeding, and the severity of pain.

If your symptoms persist, worsen, or if you notice significant bleeding, it is crucial to seek medical attention promptly. Early evaluation and treatment can help prevent complications and ensure appropriate management of your condition.

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